Texas Licensed Member Services Representative

Job Summary

A company is looking for a Member Services Representative II.

Key Responsibilities:

• Resolve inquiries from health plan members, providers, and customers while meeting productivity and service standards
• Quickly learn and apply software applications to address administrative issues related to health plan operations
• Handle calls for the Medicare Advantage plan and interpret Medicare policies and procedures

Required Qualifications:

• High School diploma or GED from an accredited program
• 5+ years of experience in a health care or health plan insurance environment
• Knowledge of health care and insurance, including Medicare prescription drug benefits and CMS regulations
• Solid knowledge of HMOPOS and TPA Plan Design and Claims Processing
• Proven ability to use various software applications and online resources